herpetic angina
Introduction
Introduction to herpes angina Herpetic angina is a disease caused by enterovirus, characterized by acute fever and sore throat. Red halos are visible in the posterior part of the soft palate, pharynx, tonsils, etc., and characteristic herpes zoster or white around. Pap (lymph nodes), mostly mild cases, have a self-limiting type (1 to 2 weeks). basic knowledge The proportion of illness: 70% Susceptible people: more common in children 3 to 10 years old Mode of infection: non-infectious Complications: acute rhinitis pneumonia meningitis
Cause
The cause of herpetic angina
(1) Causes of the disease
There are many kinds of pathogens in this disease. Coxsackie group A virus (1~6,8,10,22), herpes virus, EB virus are more common, when overworked, allergies, temperature changes, body cold or some physics , chemical factors and other stimuli, so that the body's immune ability is low, susceptible to the disease.
Common causes of acute respiratory infection in children are:
1. Insufficient respiratory barrier function, such as small children without nasal hair, can not block the rough foreign matter in the air.
2. The mucous membrane of the respiratory tract is tender and susceptible to various stimuli (cold, irritating gases, etc.), which may cause congestion, swelling and even inflammatory reactions.
3. The respiratory tract secretes bacteria, and the virus's immune substance is insufficient to fully kill the invading pathogen.
4. There are a number of cells with numerous cilia on the surface of the respiratory tract. These cilia are like a brush that is cleaned. The small particles such as dust, germs, etc. that are inhaled and adhered to the respiratory tract are swept outward and coughed out to the throat. This cilia activity in the respiratory tract of children is relatively weak, so the "self-cleaning" function is relatively poor.
In life, people need to constantly breathe to maintain their lives, so that bacteria, viruses, harmful gases, dust, etc. that enter the respiratory tract every day with inhalation are innumerable, and the above-mentioned defensive functions of children's respiratory tract are insufficient, so it is easy. Various acute respiratory infections have occurred.
(two) pathogenesis
The virus invades from the nasopharynx, the oral cavity into the respiratory tract and the local mucosa of the digestive tract, and colonizes and proliferates in the mucosal epithelial cells, as well as the pharyngeal or intestinal lymphatic tissues. The virus spreads from the primary tumor through the lymphatic channel to the local lymph nodes, or enters the blood circulation to produce a virus. Hemorrhage, reaching all organs of the body, causing various diseases.
Prevention
Herpes angina prevention
[Precaution]
Herpes angina is a common disease in children in summer. To prevent this disease, parents should pay attention to keeping children's personal and indoor hygiene, and try not to bring children to noisy public places.
[Nursing Guide]
1. Herpetic angina has obvious oral pain, most of the children have antifeeding phenomenon, should pay attention to supplement the nutrition of children, food should not be overheated, should be light, not greasy, and nutritious, can take large vein nutrition when eating difficulties mixture.
2. In order to prevent secondary infections, local use of analgesics and antiviral drugs, must pay attention to oral hygiene, the utensils used by children must be disinfected by boiling water to avoid dyeing.
3. Avoid irritating foods, such as sour, sweet, spicy, salty, hot, hard, etc., to avoid irritating the mouth ulceration caused by pain.
4. You can take 100 grams of mung beans, 50 grams of bitter gourd, 150 grams of glutinous rice, 100 grams of rice porridge, and let the children eat it after cooling.
Complication
Herpes angina complication Complications Acute rhinitis pneumonia meningitis
Often secondary to acute rhinitis, pneumonia, influenza, malaria, epidemic meningitis, can also occur alone, in addition to the pharynx, oral mucosa can also occur herpes.
This disease occurs alone, often without systemic symptoms, pharyngeal pain, affecting swallowing, infants and young children, often manifested as crying when eating, do not want to eat, submandibular lymph nodes have tenderness, sometimes accompanied by fever. Check throat Herpes often occurs.
Symptom
Herpes zoster symptoms of common symptoms Symptoms of convulsions, hyperthermia, lymph nodes, redness, fatigue, muscle pain, resuscitation, pharyngeal sputum, scattered gray... diffuse congestion of the pharyngeal mucosa
More common in children aged 3 to 10 years old, occurs in summer and autumn, the same patient can be caused by different types of viruses, the incubation period is 3 to 10 days, mostly starting with sudden high fever, reaching the peak at 24 to 48 hours, rising to 39 ~41 ° C, with headache, pharyngeal discomfort, myalgia, etc., infants often have vomiting, refusal to eat, and even febrile seizures; older children and adults often have severe sore throat, difficulty swallowing, muscle pain in the extremities, anorexia, etc. After 4 to 5 days, there was a gray papule in the pharynx, which developed into a blister and an ulcer within 24 hours. It was surrounded by a sensation of 1 to 5 mm. The lesion was often found in the anterior column of the tonsil, the soft palate and the iliac crest. Dangling, ulcer healing after 1 to 5 days, usually within 3 days of fever, symptoms disappear, the disease has a good prognosis.
Acute lymphatic angina is a variant of herpes angina caused by coxsackievirus A10. It is similar to typical angina, but does not progress to blisters and ulcers. There is only lymphocyte infiltration. A grayish white pimples formed, surrounded by a flush.
The disease has a trend, common in infants and young children, the clinical features of sudden high fever accompanied by sore throat, headache, anorexia, and often neck, abdomen and limb pain, vomiting and convulsions often occur in infants, oral mucosa within 2 days of onset There are a few (rarely more than 12) small (1~2mm in diameter) gray-white herpes, surrounded by redness, more common in the front of the tonsils, but also in the soft palate, tonsils, uvula, tongue, etc. Within 24 hours, the blisters collapse into shallow ulcers, the diameter is generally less than 5mm, healed within 1-5 days, and the complications are rare: the symptoms usually disappear within 7 days, and can produce long-lasting immunity after infection, but other types of viruses in group A Or other enteroviruses may also cause recurrence.
The disease occurs alone, often without systemic symptoms, the child manifests as acute onset, sudden high fever, early with a runny nose, and then older children will complain of oral pain or refusal to eat, and smaller babies are irritated. Crying, drooling, yellow urine, shortness, dry stool into a ball, when examined, the child's upper jaw, oral mucosa, posterior pharyngeal wall, tonsil and other oral mucosa appeared grayish white herpes, herpes broke in about 1-2 days Ulceration ulcers, general herpes angina often accompanied by bleeding gums, odor in the mouth, accompanied by submandibular lymph nodes, but rarely affect the skin outside the mouth.
Examine
Herpes angina
According to the onset of acute fever, there is papular vesicular damage in the mouth and the culture of Coxsackie or Echovirus can be diagnosed. It is differentiated from some viral diseases with buccal buccal disease. Laboratory tests for increased white blood cells, taking pharyngeal blister fluid Or stool, tissue culture or inoculation in suckling mice can obtain the pathogenic virus, and the acute phase and recovery period serum can be taken for special neutralizing antibody, complement fixation or hemagglutination inhibition test to help confirm the diagnosis.
Diagnosis
Diagnosis and diagnosis of herpetic angina
diagnosis
Diagnosis can be based on symptoms and characteristic oral lesions, preferably by isolation of the virus from the lesion or by elevated levels of characteristic antibodies, but these tests are not recommended for routine use, and differential diagnosis includes herpetic stomatitis (features) For any season, it can develop a larger, longer lasting ulcer), recurrent aphthous ulcers and Bednar aphthous ulcers (rarely occurring in the pharynx, but generally no systemic symptoms), Coxsackie A group 10 virus will also Caused similar lesions (lymph node pharyngitis), but the oropharynx lesions were prominent, showing a white to yellow nodules, treatment for symptomatic treatment.
Herpetic angina is a special febrile disease in children. The clinical features are sudden high fever accompanied by sore throat, headache, anorexia, and often pain in the neck, abdomen and limbs. Vomiting and convulsions often occur in infants. Within 2 days of the disease, a small number (rarely more than 12) of small (1~2mm in diameter) grayish white herpes appeared in the mouth, surrounded by redness, more common in the front of the tonsils, but also in the soft palate, tonsils, uvula, tongue Department, etc., in the next 24 hours, the blisters will become shallow ulcers, the diameter is generally less than 5mm, healed within 1~5 days, the complications are rare, the symptoms usually disappear within 7 days, and can produce long-lasting immunity after infection, but A Other types of viruses or other enteroviruses in the group may also cause recurrence.
Differential diagnosis
Identification with some viral diseases with buccal buccal.
